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OPTIMIZATION OF EARLY DIAGNOSTICS OF PRECONCTIC DISEASES OF THE UTERINE CERVIC
Ahmedova N.M.1, Ruhiddinova N.N.2 Email: Ahmedova17162@scientifictext.ru
1Ahmedova Nilufar Mahmudovna - Candidate of Medical Sciences, Associate Professor, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY № 1; 2Ruhiddinova Nazira Nuriddinovna - graduate Student, DIRECTION: OBSTETRICS AND GYNECOLOGY, ANDIJAN STATE MEDICAL INSTITUTE, ANDIJAN, REPUBLIC OF UZBEKISTAN
Abstract: in this article, we will focus on the diagnosis, comparative diagnosis and treatment of cervical cancer cases, which have become a widespread problem among women in recent years and have led to their death.
In recent years, in economically developed countries, against the background of a general decrease in the incidence of cervical cancer, due to the introduction of screening programs into practice, a new phenomenon has been discovered in a number of countries - an increase in incidence at a young age - up to 35 years.
Cervical cancer (CC) is one of the most common malignant tumors in women. According to the WHO, about 500 thousand new cases of cancer of this localization are detected annually in the world, ranking first in the structure of morbidity and mortality among all malignant neoplasms of the female genital organs.
Keywords: cervical cancer, comparative treatment and diagnosis, gynecological and oncological gynecological diseases.
ОПТИМИЗАЦИЯ РАННЕЙ ДИАГНОСТИКИ ПРЕДРАКОВЫХ
ЗАБОЛЕВАНИЙ ШЕЙКИ МАТКИ 12 Ахмедова Н.М. , Рухиддинова Н.Н.
1Ахмедова Нилуфар Махмудовна - кандидат медицинских наук, доцент, кафедра акушерства и гинекологии № 1; 2Рухиддинова Назира Нуриддиновна - студент магистратуры, направление: акушерство и гинекология, Андижанский государственный медицинский институт, г. Андижан, Республика Узбекистан
Аннотация: в этой статье мы сосредоточимся на диагностике, сравнительной диагностике и лечении случаев рака шейки матки, которые стали широко распространенной проблемой среди женщин в последние годы и привели к их смерти. В последние годы в экономически развитых странах на фоне общего снижения заболеваемости раком шейки матки за счет внедрения в практику программ скрининга в ряде стран было обнаружено новое явление - рост заболеваемости на юный возраст - до 35 лет.
Рак шейки матки (РШМ) - одна из самых распространенных злокачественных опухолей у женщин. По данным ВОЗ, ежегодно в мире выявляется около 500 тысяч новых случаев рака данной локализации, занимая первое место в структуре заболеваемости и смертности среди всех злокачественных новообразований женских половых органов.
Ключевые слова: рак шейки матки, сравнительное лечение и диагностика, гинекологические и онкологические гинекологические заболевания.
UDC 618. 146 - 072.5
Relevance. Cervical cancer (CC) is one of the most common malignant tumors in women. According to the WHO, about 500 thousand new cases of cancer of this localization are detected annually in the world, ranking first in the structure of morbidity and mortality among all malignant neoplasms of the female genital organs [8].
In recent years, in economically developed countries, against the background of a general decrease in the incidence of cervical cancer, due to the introduction of screening programs into practice, a new phenomenon has been discovered in a number of countries -an increase in incidence at a young age - up to 35 years [2].
Despite the fact that in many countries of the world there is a downward trend in morbidity, mortality rates from cervical and uterine cancer (CC) have remained practically unchanged over the past 20 years. This is due to the fact that the disease very often (in 46 cases out of 100) is detected already in the late stages [1].
In the world, 12,000 cases of cervical cancer are registered annually (2nd place after cancer of the uterine body), in 40% of them the disease is diagnosed in stages III - IV. In a number of territories, a high incidence of cervical cancer is constantly observed [4].
The average standardized rate of morbidity (10.8 cases per 100 thousand women) and mortality (5.0 per 100 thousand women) have stabilized in recent years, however, at a young age, the incidence annually increases by 2% [6].
Cervical cancer refers to tumors of external localization. It is available not only for visual observation, but also for detection at the early stages of development during mass preventive gynecological examinations of women. Mass surveys of women have a 50-year history. However, in the context of socio-economic changes in the country, along with a violation of the preventive orientation of health care, screening programs aimed at the prevention and early diagnosis of cancer in general and cervical cancer in particular have been curtailed [2,7].
The occurrence of cervical cancer can be prevented by detecting and treating precancerous diseases. Distinguish between primary and secondary prevention of cervical cancer. Primary prevention consists in the prevention of sexually transmitted diseases, abstinence from early onset of sexual activity, the use of mechanical barrier means for contraception, in the full restoration of the integrity of the cervix in case of injury during abortion or childbirth, smoking cessation [5].
Secondary prevention of the disease consists in identifying and eliminating precancerous changes through a systematic examination of women and their adequate treatment.
From the above, it follows that the issues of RHYTHM prevention and diagnosis of the initial stages of carcinogenesis are still the most important medical and social problem.
In the Republic of North Ossetia - Alania (RNO-A), the problem of cervical cancer has not been studied by anyone. The standardized incidence rate of cervical cancer is 13.04 higher than the national average of 10.8 per 100 thousand female population, and the neglect of cervical cancer is also higher than 12.9 and 11.7, respectively. In addition, the highest mortality rate in the Southern Federal District in North Ossetia-Alania is 7.8 per 100 thousand of the female population [3].
The above facts convincingly testify to the relevance and need to improve the methods of cervical cancer screening in the RNO-Alania, the search for new simple, economically affordable and at the same time effective methods of prevention and early diagnosis of cervical cancer, in order to ensure the timely treatment of this serious and dangerous disease.
Purpose of the study. The aim of the study is to increase the effectiveness of organizational, diagnostic and therapeutic measures aimed at early detection of background, precancerous diseases and cervical cancer.
Materials and research methods. To accomplish this task, we selected 65 women with cervical cancer who underwent special treatment.
Research results. The incidence of cervical cancer in the Republic of North Ossetia-Alania has increased 1.3 times over 15 years (from 10.87 in 1989 to 14.5 in 2003). The
incidence rate among rural residents (14.54) is slightly lower than the incidence of cervical cancer among urban residents (16.87). Mortality from cervical cancer during this period decreased by 1.2 times (12.3 and 14.9, respectively).
The formation of groups of increased risk of cervical cancer with a high and medium degree of its probability is carried out on the basis of the subjective factors of probable detection established by us (pulling pains in the lower abdomen, mucopurulent discharge from the genital tract, bloody discharge) and objective factors of probable detection (degree of anemia, flora of the vagina, changes in the mucous membrane of the cervix).
We have established risk factors for the development of cervical cancer: age over 50 years, overweight, high growth, living in the city, early onset of sexual activity, history of sexually transmitted diseases, history of cervical pathology, cervical trauma during childbirth, a large number of abortions.
The method of taking material for cytological examination during colposcopic examination, improved with the help of the tool developed by us, made it possible to increase the detection rate of cervical cancer by 1.5 times.
The system of organizational forms of screening developed by us made it possible to increase the active detection of early forms of cancer and precancerous diseases of the cervix by 2.3 times and 2.1 times, respectively.
Conclusion: The developed method of forming groups of patients with a high probability of developing and detecting cervical cancer contributes to the improvement of early diagnosis, adequate treatment and prevention of cervical cancer in the conditions of the polyclinic service of the general medical network of the Republic of North Ossetia-Alania.
The simplicity, availability and minimization of costs in the implementation of the developed system of organizational forms of screening allows the outpatient service specialists to increase the detection rate of background and precancerous diseases of the cervix uteri by 1.4 times.
The development of a tool for taking material for cytological examination in patients with underlying diseases of the cervix uteri made it possible to increase the detection rate of cervical cancer by 1.5 times.
References / Список литературы
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